Neuroblastoma natural history

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Complications

• Treatment-resistant diarrhea (vasoactive intestinal peptide secretion, among 4% of cases)
• Horner's syndrome (cervical sympathetic chain compression, among 2.4% of cases)
• Opsoclonus myoclonus syndrome and ataxia (paraneoplastic syndrome, among 1.3% of cases)
• Hypertension (catecholamine secretion or renal artery compression, among 1.3% of cases)
• Transverse myelopathy (tumor spinal cord compression, among 5% of cases)
• Anemia and decreased immunity (bone marrow metastasis)

Prognosis

• Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary. However, the prognosis of neuroblastoma is generally regarded as poor.
• The table below lists the prognostic factors for neuroblastoma patients:

Prognostic Factor	Description
Patients Age	Patients older than 18 months of age are associated with poor prognosis.
Tumor Stage	Advanced INSS stages of neuroblastoma are associated with poor prognosis.
Tumor Grade	An unfavorable Shimada histology index is associated with poor prognosis.
Schwannnian Stroma	A reduced schwannian stroma background content on histological analysis is associated with poor prognosis.
Mitotic-karyorrhectic Index	A high mitotic-karyorrhectic index is associated with poor prognosis.
Genetics Mutations	Chromosome 1p deletion, chromosome 11q deletion, and N-MYC oncogene amplification are associated with poor prognosis.
Response to Treatment	Patients whose neuroblastoma responds to treatment and goes into complete remission have a better prognosis than people whose cancer does not respond to the initial treatment.